Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1984 Dec;47(12):1338–1341. doi: 10.1136/jnnp.47.12.1338

Conservative treatment of delayed cerebral radiation necrosis.

P J Shaw, D Bates
PMCID: PMC1028144  PMID: 6512555

Abstract

A 63-year-old man developed delayed cerebral radiation necrosis following radiotherapy to a nasopharyngeal carcinoma. Complete resolution of his neurological deficit resulted from corticosteroid therapy alone. Serial CT scans showed the disappearance of the patients' mass lesion. The literature on cerebral necrosis following radiotherapy of extracranial neoplasms is reviewed with particular emphasis on management.

Full text

PDF
1338

Images in this article

1339Image
on p.1339

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Amico G., Canger R. Radionecrosi cerebrale tardiva ad evoluzione ipertensiva endocranica. G Psichiatr Neuropatol. 1967;95(3):533–545. [PubMed] [Google Scholar]
  2. Bernasconi V., Giovanelli M., Perria C., Wildi E. La radionecrosi cerebrale tardiva ad evoluzione pseudo-tumorale. Minerva Neurochir. 1967;11(1):28–41. [PubMed] [Google Scholar]
  3. Byfield J. E. Ionizing radiation and vincristine: possible neurotoxic synergism. Radiol Clin Biol. 1972;41(3):129–138. [PubMed] [Google Scholar]
  4. CHANDLER A., TUCKER F. C., HERZBERGER E. E. LATE RADIATION NECROSIS OF THE BRAIN. Wis Med J. 1964 Jul;63:297–300. [PubMed] [Google Scholar]
  5. Cambier J., Escourolle R., Lechevalier B., Delaporte P., Lhuillier M. Radiolésion retardée du cerveau consécutive à l'irradiation d'un épithéliome spino-ccllulaire du cuir chevelu par le bêtatron. Rev Neurol (Paris) 1972 Mar;126(3):179–190. [PubMed] [Google Scholar]
  6. DUGGER G. S., STRATFORD J. G., BOUCHARD J. Necrosis of the brain following roentgen irradiation. Am J Roentgenol Radium Ther Nucl Med. 1954 Dec;72(6):953–960. [PubMed] [Google Scholar]
  7. Diengdoh J. V., Booth A. E. Postirradiation necrosis of the temporal lobe presenting as a glioma. Case report. J Neurosurg. 1976 Jun;44(6):732–734. doi: 10.3171/jns.1976.44.6.0732. [DOI] [PubMed] [Google Scholar]
  8. Eyster E. F., Nielsen S. L., Sheline G. E., Wilson C. B. Cerebral radiation necrosis simulating a brain tumor. Case report. J Neurosurg. 1974 Feb;40(2):267–271. doi: 10.3171/jns.1974.40.2.0267. [DOI] [PubMed] [Google Scholar]
  9. FOLTZ E. L., HOLYOKE J. B., HEYL H. L. Brain necrosis following X-ray therapy. J Neurosurg. 1953 Jul;10(4):423–429. doi: 10.3171/jns.1953.10.4.0423. [DOI] [PubMed] [Google Scholar]
  10. Hopewell J. W., Wright E. A. The nature of latent cerebral irradiation damage and its modification by hypertension. Br J Radiol. 1970 Mar;43(507):161–167. doi: 10.1259/0007-1285-43-507-161. [DOI] [PubMed] [Google Scholar]
  11. Julow J., Slowik F., Kelemen J., Gorácz I. Late post-irradiation necrosis of the brain. Acta Neurochir (Wien) 1979;46(1-2):135–150. doi: 10.1007/BF01407687. [DOI] [PubMed] [Google Scholar]
  12. Krayenbühl H., Rüttner J. R. Röntgenspätschäden des Schläfenhirns nach Hochvoltbestrahlung maligner Tumoren des Epipharynx. Schweiz Med Wochenschr. 1973 Feb 17;103(7):225–231. [PubMed] [Google Scholar]
  13. Kusske J. A., Williams J. P., Garcia J. H., Pribram H. W. Radiation necrosis of the brain following radiotherapy of extracerebral neoplasms. Surg Neurol. 1976 Jul;6(1):15–20. [PubMed] [Google Scholar]
  14. LOWENBERG-SCHARENBERG K., BASSETT R. C. Amyloid degeneration of the human brain following X-ray therapy. J Neuropathol Exp Neurol. 1950 Jan;9(1):93-102, illust. doi: 10.1097/00005072-195001000-00006. [DOI] [PubMed] [Google Scholar]
  15. Littman P., James H., Zimmerman R., Slater R. Radionecrosis of the brain presenting as a mass lesion: a case report. J Neurol Neurosurg Psychiatry. 1977 Aug;40(8):827–829. doi: 10.1136/jnnp.40.8.827. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mandybur T. I., Gore I. Amyloid in late postirradiation necrosis of brain. Neurology. 1969 Oct;19(10):983–992. doi: 10.1212/wnl.19.10.983. [DOI] [PubMed] [Google Scholar]
  17. Marra A., Giuffrè R. Late cerebral radionecrosis. Eur Neurol. 1968;1(4):234–246. doi: 10.1159/000113664. [DOI] [PubMed] [Google Scholar]
  18. Martins A. N., Johnston J. S., Henry J. M., Stoffel T. J., Di Chiro G. Delayed radiation necrosis of the brain. J Neurosurg. 1977 Sep;47(3):336–345. doi: 10.3171/jns.1977.47.3.0336. [DOI] [PubMed] [Google Scholar]
  19. Matsumura H., Ross E. R. Delayed cerebral radionecrosis following treatment of carcinoma of the scalp: clinicopathologic and ultrastructural study. Surg Neurol. 1979 Sep;12(3):193–204. [PubMed] [Google Scholar]
  20. Mikhael M. A. Radiation necrosis of the brain: correlation between computed tomography, pathology, and dose distribution. J Comput Assist Tomogr. 1978 Jan;2(1):71–80. [PubMed] [Google Scholar]
  21. Okeda R., Shibata T. Radiation encephalopathy--an autopsy case and some comments on the pathogenesis of delayed radionecrosis of central nervous system. Acta Pathol Jpn. 1973 Nov;23(4):867–883. doi: 10.1111/j.1440-1827.1973.tb02781.x. [DOI] [PubMed] [Google Scholar]
  22. Pardo-Mindán F. J., Delgado G., Ezcurdia J., Quintanilla E. Delayed cerebral radionecrosis following treatment of basal cell carcinoma. Arch Neurol. 1979 Jun;36(6):382–383. doi: 10.1001/archneur.1979.00500420092015. [DOI] [PubMed] [Google Scholar]
  23. Piazza G., Gaist G., Padovani R., Morrone B. Necrosi cerebrale pseudotumorale tardiva secondaria ad irradiazione di epitelioma del cuoio capelluto. Pathologica. 1974 Sep-Oct;66(959-960):383–396. [PubMed] [Google Scholar]
  24. Price R. A., Jamieson P. A. The central nervous system in childhood leukemia. II. Subacute leukoencephalopathy. Cancer. 1975 Feb;35(2):306–318. doi: 10.1002/1097-0142(197502)35:2<306::aid-cncr2820350203>3.0.co;2-j. [DOI] [PubMed] [Google Scholar]
  25. Rottenberg D. A., Chernik N. L., Deck M. D., Ellis F., Posner J. B. Cerebral necrosis following radiotherapy of extracranial neoplasms. Ann Neurol. 1977 Apr;1(4):339–357. doi: 10.1002/ana.410010406. [DOI] [PubMed] [Google Scholar]
  26. Sharma U., Tandon P. N., Rath G. K., Pant G. S., Singhal R. M., Ahuja G. K., Roy S. Delayed brain necrosis in irradiated adenoid cystic carcinoma nose--a case report. Indian J Cancer. 1980 Mar;17(1):59–63. [PubMed] [Google Scholar]
  27. Sheline G. E., Wara W. M., Smith V. Therapeutic irradiation and brain injury. Int J Radiat Oncol Biol Phys. 1980 Sep;6(9):1215–1228. doi: 10.1016/0360-3016(80)90175-3. [DOI] [PubMed] [Google Scholar]
  28. Takeuchi J., Hanakita J., Abe M., Handa H. Brain necrosis after repeated radiotherapy. Surg Neurol. 1976 Feb;5(2):89–93. [PubMed] [Google Scholar]
  29. de S Queiroz L., da Cruz Neto J. N. Late pseudotumoral brain necrosis following irradiation of a scalp neoplasm. Case report. J Neurosurg. 1976 Nov;45(5):581–584. doi: 10.3171/jns.1976.45.5.0581. [DOI] [PubMed] [Google Scholar]
  30. van Dellen J. R., Danziger A. Failure of computerized tomography to differentiate between radiation necrosis and cerebral tumour. S Afr Med J. 1978 Feb 4;53(5):171–172. [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES